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Originally Posted by detbuch
That's the beauty of a large system. If someone dares to talk about one part of it, they can be dismissed without discussion since their concern is so minimal compared with the massive bureaucracy that comprises the system. Sort of like all encompassing centralized government.
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No, it just means the subject has to be looked at in a broader context. This myopic focus our political system seems to have makes any effort towards real policy impossible.
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I don't know if they do. But they have specific, spelled out, benefits and limitations. And they can be bullied or convicted by government aided by sharp lawyers into paying for things they might object to. It's kind of difficult to convince the government to bully or convict itself in such cases (unless votes are in the balance). And private insurers provide a plethora of "versions," and, until the ACA, were not forced to provide certain things in all "versions." You were more able to get what you paid for rather than being coerced to pay for what you were forced to get.
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Funny, for the benefits and limitations being so specific and spelled out I still have a terrible time trying to determine what's actually covered.
Are people really getting what they pay for if they don't even know what they're getting?
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And . . . how, again, was the ACA going to make this better and "more affordable"? Oh yeah, that's right . . . it was going to force the subsidization of some, without choice, at the expense of others. Right . . . that's how large bureaucratic centralized socialistic systems work. In every respect. Except for some very "special" cases, like abortion, where choice is paramount.
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I don't know if the ACA was intended to address VA issues.
Cost cutting comes from reforms more than just economies of scale. For instance one of the big changes the reform makes is place the emphasis on the value of care rather than the volume. Doing so has the potential to eliminate a tremendous amount of waste while improving quality.
I remember reading an article in HBR (by Porter?) some years ago stating exactly this.
-spence